Thursday, August 14, 2008

How to evaluate marketing claims for medical treatments

We live in an age of celebrity spokespersons. In April I wrote about Jenny McCarthy's new status as an advocate for a fabled connection between vaccines and autism. That triggered a thoughtful email from Tim, who wrote:
You were kind in your description of Jenny McCarthy's credentials. She is very similar to my wife and me. We know what we have read, we know what we have seen happen to our family and in the life of our son - but for most of us that produces at best a great deal of passion. Not a great deal of factual knowledge. So our headlines seem full of people speaking on topics that I can't figure out why we are listening to them. 'Nuff said!

My question is this. How do scientists (and pharma in general) respond to the suspicion that many parents feel when we are told that this med or that med is safe and find out later it really wasn't. Point in case is the same issue of USA Today that your comments appeared. On the front page the headline reads: "Reports: Data on Vioxx misused; Documents suggest risk was downplayed."

How do we keep trusting big pharma, our governmental regulatory agencies and science when those headlines are more and more commonplace?

This was a great question. Here's my reply, which I hope is useful to our other readers.
Dear Tim,

Thank you for your very thoughtful letter. You are right that my article has triggered a wave of mail. However, I will try to address your concern as well as I can.

First, I should point out that you are combining two groups into a single category: scientists and big pharma. Many scientists don't trust big pharma either. Unfortunately, it's becoming increasingly difficult for readers to distinguish between scientists with no ax to grind and big companies trying to manipulate their data to sell products.

If journalists are careful to note conflicts of interest, then there is some prayer of identifying the straight shooters, but not otherwise. Sadly, the government agencies that are supposed to protect the public have recently been given over to commercial interests. Many scientists are upset about this too. Until these agencies are reformed, one recourse in deciding who to trust is to follow the money. I often do this myself when reading even a scientific article.

Second, in addition to funding, one key phrase to look for in an article, a press release, or even the abstract of a scientific paper is "peer-reviewed study." Another is "controlled study" or "control group," and meta-analyses are hard to fake. There may be others, which I need to think of. This point is helpful not only when thinking about pharma but also when dealing with anecdotal claims for experimental treatments.

Again, I appreciate your letter. I wish you and your family all the best.

Yours sincerely,
Sam Wang

I should say that the same cautions also apply to treatments that are out of the mainstream. The list of products sold using marketing claims that are unsupported by science is long:

  • Brain training software

  • Brain scanning to diagnose and treat attention deficit and hyperactivity disorder (ADHD)

  • Balancing exercises for dyslexia

  • Chelation therapy for autism

  • Nutritional supplements to aid brain function

That's just a few. Buyer beware!


Robert Brown said...

Very happy to run across your blog by searching the list of those interested in neuroscience. I've bookmarked and look forward to looking in on you in the future. I'm especially pleased that you're providing a generous public service by exposing exagerrated claims by both pharmaceutical companies and naturla practioners.

Anonymous said...

My name is Tony Gomez and i would like to show you my personal experience with Vioxx.

I am 56 years old. Have been on Vioxx for 2 years now. Everybody that works for the fda that oked this drug should be put in jail.

I have experienced some of these side effects -
heart attack hardening of the arteries and nerve damage in my feet

I hope this information will be useful to others,
Tony Gomez